Fat Camps For Obese Children

Mother is asking us to pay for her obese child to go to a Fat Camp, run by Professor Paul Gately.


The child is blaming the mother for making her fat, perhaps the child is right and perhaps it is just bad luck. There are many reasons why a child is fat. But looking at the mum the child might be right, mum looks like she needs help as well.


There are thousands of obese children out there, who have obese parents who haven't taken a look at  their own relationship with food. Nothing will change unless everything changes in the family.


If you know someone in the NHS who has anything to do with this family, get them to have a word with me. I can give them some advice.


Changing a weight problem in the family is long term, it is an enormous ask, it takes a village to heal a child and her parents, not just a fat camp.  Perhaps I should write a longer article about how to help overweight children on our website, its sorely needed. But fat camps have to be the last resort.


see my blog on http://www.eating-disorders.org.uk

One Fat Child Inside A Perfect Storm

I write this as a psychologist specialising in obesity, childhood obesity and eating disorders; a member of the National Obesity Forum and an All-Party Parliamentary Obesity Group. I am a spokesperson for the British Psychological Society on all matters relating to eating and obesity, and I am Founder of the National Centre for Eating Disorders.

Every parent dreads getting the dreaded fat letter or a summons from the school. One such parent I know has had such a summons. Healthy schools policies now mean that schools are taking some responsibility for the wellbeing of children, by providing healthy lunches and in some cases banning high fat-sugar snacks. I applaud these policies to some extent. They are also weighing children to alert the parents about potential dangers such as increasing BMI or anorexia in older children. This is controversial and my thoughts about in-school weighing belong elsewhere. However in this case, the child aged 10 looks and is fatter than his classmates. And the parents have been told that Social Services may be invoked.

Even worse, the child himself has been told that his weight is a matter of concern. This the first time that the child has had negative feedback from an adult.

Now where a child’s weight is concerned, some parents are ignorant about what to feed their children and some try hard to feed their child a healthy diet but are thwarted by all that is out there and some parents are too lazy to bother thinking about it all. They say, let children be children and eat what they like.

Some mothers have eating problems and buy food for their children so that they have an excuse to eat it themselves. Some parents have a child who gains weight extremely easily because they were born that way. Most onlookers blame the parents if the child is fat. They think that the parent is over feeding their child.

Or they assume that the children are compulsive overeaters, sneak eaters and so on, that they are unhappy and that their weight gain signifies underlying psychological problems. They might look at the child and discover that the child is eating more than their peers. This would be normal because a fat child needs more calories than a thin child; they have more muscle as well as fat to carry around.

The parent has refused permission for the school to weigh her son. She knew that her child was large, and the diet at home is reasonably sound. I endorse her decision, since the weighing was not routine and the child would have been singled out, a horrible experience for a young person growing his wings. Now she has been told that the school is sending out for counselling for the child. The child will once again be singled out.

First do no harm. Identifying a fat child is one thing, knowing what to do about it is something else, which is why I say the following. By all means weigh children and inspect their size. But be clear that you know what to do about it so that you do not harm the child. Some children will need help and some will not. But in some cases insensitive intervention will create a tragedy. For example, is the next step to put the child on a diet? There is very strong evidence that 99% of children who are put on a diet gain weight excessively afterwards. They develop unreasonable attachments to food which is denied them; they suffer from feeling different from their peers and their self esteem can fall. My eating disorder casebooks are full of people who have been dieted or given pills as children; told that they are unacceptable and thus unlovable.

These are the circumstances for a perfect storm brewing up in which everybody could be hurt. Everyone needs to take a big step back. I would offer the following advice.

1    I would ask the school to wait, do nothing and revisit the situation in a few months time. During that time the professionals involved need to learn more about how to help fat children. They should not just swing into action with panic strategies unless there are other strong reasons for concern. They should liaise with the parents and agree together the best way to proceed.

2     The school must not be led to believe that a fat child is an unhealthy child; this is a myth. While there are health risks associated with being overweight the risks are greater for thin children who do no activity and who eat poorly at home. I would refer to the school to research the HAES research (healthy at any size). The school needs to have a written policy guided by appropriate health professionals for managing children they think have eating or weight problems.

3    The school must immediately remove any pressure on the child that would lead to him feeling different from his peers and must be open to listening to the child if he is being teased.

4   Let the parents, with some help if necessary, take a fearless inventory of the food and eating patterns at home. Even where the parent has expertise and knowledge about healthy nutrition, there are always some small improvements that can be made. This will help the child be more healthy; this will not necessarily result in weight loss. The school must be fully aware of this.

5    Neither the school nor the parents must fall into the trap of insisting that the child do more exercise if he is already doing a reasonable amount. There is no association between insisting on programmed activity that the child does not enjoy and long term weight control. Limiting TV at home is useful but not only for managing weight.

6   At the age of 10, the child is approaching puberty. Children tend to gain weight at this time to provide the energy for a huge amount of pending growth. It is also a time critical for developing self esteem. The parent and the school must do everything possible to support the self esteem of the child and to give them well paced information about nutrition in a sensitive way. This will put the child in a good position to make their own decisions about weight control when they are old enough to be autonomous.

7   Counselling should only be given if the child really wants it and if there are really good reasons for concern - which should be made clear in writing by the school. The parents should be open to giving assistance for weight loss only when the child asks for it. There are good and bad ways to help children lose weight and this needs to be discussed with an expert in the field. Not a doctor and definitely not a school nurse.

If anyone has a problem with a child who is fat, I am willing to act as an advocate for them. It is hard, not a crime, to be the parent of a child who is fat.

Get A Grip: Love, Cherish And Protect Fat Children

Two articles in The Times Saturday 11 February 2012; the first worrying about children who consider themselves fat when they aren’t. The second, a cry for help from Lucy Cavendish, mother of a fat child who doesn't understand her son’s fatness and doesn't know what to do about it.

Lets take the former first which deserves a blog to itself. God (or whatever) save our children from parents who make comments about weight, their own willpower or lack of it and who flaunt their own obsessive attachment to the gym, pilates or running marathons.

The second article resonated with me more, having it on good authority that being the Parent Of A Child Fatter Than Other Children (PFOC) has its challenges.

I understand that Lucy, like many other PFOCS, will first try to figure out why her child is fat. Is it the genes, is it something she has done, or something about the character of the child. She seems to be blaming all of the above. She once cooked like Nigella and now one of her children is paying the price. Or perhaps he just is lazy or is having a love affair with food. There was a fat ancestor somewhere in the past.

Even if it isn’t her fault, it is her responsibility to do something about it. Everyone tells her so. Some people are telling her to put her son on a diet. HORRORS! Please find her and warn her that dieted children are more likely to gain weight even faster than before the diet. It doesn't work to put children on diets.

When you have a fat child, people think you are a bad mother or at least an irresponsible mother. People will say how can you let your child get like that. Lucy feels guilty when she buys fattening foods and is bending over backwards to put everyone at home on a healthy eating programme. That sounds fine and will convince her that she is being a good mum.  But, Lucy, if you are reading this, that doesn't work either.  For every PCFOC buying normal foods in a supermarket there are a dozen parents buying ordinary food with normal skinny children. Many children just don't gain weight.

The Government has decided to wage war on the fat child with warnings about health risks and risks to emotional well-being. In some ways they are right and Lisa is correctly afraid that a fat child is probably going to be a fat adult. But many adults are fat who were never fat as children.  I think it is these adults who find it hardest to manage their eating habits, since they were never called into question when they were young.

The days of bad interventions are gone. Doctors no longer give slimming pills to children as they did but rest assured, they don't know what else to do. Obesity is the physician’s Achilles heel.  Instead we have do-gooding, Jamie Oliver, bless him, and earnest strategies trying to foster healthy eating for our kids. We have the dreaded “fat letter” and a fat lot of good that is going to do. We even have a MEND child obesity programme which appears to have failed Lisa and her son. Although MEND received a gazillion pound grant, I would love to meet just one cured-fat success story, a fat child made thin. I haven’t yet.

There is no doubt that there are some lazy, irresponsible and unknowledgeable parents who stuff their children full of junk. There are parents who simply do not know that their child is fat, because they do not know how to interpret what they see. Despite what we are led to think, I believe that these are in the minority.

The rest of us have to do daily battle, with our need to defend ourselves from criticism, and with the unending responsibility to conduct a battle, which we cannot win. There is a limit to the control we can exert and limit to the miles we can force these little ones to run. We risk doing damage in the process; a child deprived of treats will only want them more. We stop just appreciating our fat children and envelop them in the pall of our own anxiety, always wondering what to do that will work this time.

To the mother of a fat child I would say this.  Really there is nothing you can do. This is a child who above all needs to be loved and celebrated, learn to view their difference as a gift to help you to rise above yourself. Let them eat all they want; do not try to convince them that they cannot be hungry; do not scrutinize their portion sizes; they really do need more than thin children.

Above all, deprive the child of nothing that you would not let them eat if they were thin. By all means take them out for a walk for fun, but do not heed the advice to deprive them of their TV and to force them onto the football pitch.

The child who is fully accepted and loved at home will be better able to overcome the difficulties they will face outside. To any young and vulnerable person, teasing and bullying is the worst thing that can happen. Above all it mustn’t happen at home with guarded comments such as “You would look better in that if you were a bit thinner.”  A zero tolerance policy of teasing among siblings should also be in place.

Instead of trying to fix the child’s weight, fix their ability to manage these torments and to overcome them. You may need to call on professional help to keep their self esteem intact.  Above all, you must find a way to let them know that it is not their fault. Nor, when they are children is it their responsibility to do something about it. Nor, strangely enough is it yours for now.

Having worked unceasingly with fat people for decades, I am now convinced that fatness is a disease that can only be managed, never cured. The best chance a fat child has of losing weight is to do it for themselves, when they are older, in time and in the best way for them.  They have a far better chance of managing their weight in the future if you are able to give them a solid sense of self worth and self respect in early life.

So, if you are going to stop trying to manage their weight, what can you do? If I did have a checklist, it would contain some of the following;

Adore and be proud of your fat child, give them loads of hugs and listen to their problems.

Engage the school, make sure you let them know that your strategy for your child is long term and alert them to let you know if there are problems.

Make sure he knows that weight is not his fault. You might need help to put this in the right words. If he thinks it isn’t fair, he is right.

 Ignore comments or assumed comments from others. Make sure that everyone in the family reads this blog.

Tell well-meaning others that diets make fat children fatter. Tell the child that missing meals is fattening.

 Do not diet yourself, or make weight comments about yourself or others, do not praise beautiful children, do not use the child to compete with you in a weight loss programme.

 Help your child to love a large range of foods.

Teach your fat child how to cook (all foods including treats).

Do not ban any food, under any circumstances including visits to Macdonalds, do not make comments, but use substitutions, like sorbet rather than ice cream for the family.

 Get help if necessary to teach her how to combat teasing including Facebook bullying.

 Make sure she is doing things she enjoys, from ice skating to dancing or tweeting.

 If your child wants to diet, do NOT quickly agree and I advise some expert help, such as from me!

If she is bingeing or secretly eating, she is deeply alone and unhappy. Spend time with her and find out what she is feeling.

If you have any questions or concerns, email me at admin@ncfed.com and meanwhile, celebrate your fat and hungry child.

Obese Children Are Not The Enemy?

This was the title of a message from a "working think tank" which landed in my postbox this week. This is supposed to be promoting "Integrity and Dignity". What? Where does the enemy word come from?

At the same time I met an authoress and journalist, Tanith Carey who has written "Where Has My Little Girl Gone? How to protect your daughter from growing up too soon." We had a conversation about weight problems in children.

I have it on good authority from a very good friend that it's hard being the mother of an overweight child. Everyone will look at the parents and say;
"Why don't you put him on a diet" when some of us know that dieting only makes an overweight child fatter in the long run. Much fatter.
"Don't let them eat ice cream" - when all of their slim friends are eating ice cream and no-one gives a damn. Anyway, restricting food only makes it more desirable, so how do you get the balance right?

"Make them do more exercise" when you take them swimming and they just want to waft like basking dolphins in the shallow end or play around like the other children.
"Give them healthy lunchboxes" when they ALSO go into the cafeterias at school and swap carrots for chips with their friends.
"Switch off the TV" when their self esteem is shaky anyhow and they want to be tweeting and Facebooking or following East Enders like all their other friends.

"Help your child to grow out of their weight problem by keeping their weight steady as they grow". Easier said than done, anyway do you want to be weighing the child every week and controlling everything they eat and do?

Some parents are lazy and some are thwarted by the culture at large and some are ignorant. My friend whose authority I lean on, knows everything there is to know about healthy eating and activity, and lives in a healthy environment and his very fat child loves fruit and vegetables. 

Working with an overweight child is a very, very complex task. Parents need help because they can feel like a bad parent if they have a fat child. The parent needs help and support to deal with their shame.

Experts have to stop talking in generalisations about what to do. Some children have a much  harder job than other children managing their weight and the situation is going to become worse before it gets better, if at all. If a parent is worried about their child's weight problem they need personal advice and sometimes that advice may be to do very little for the moment.

Food for thought.